INTELLIGENCE IN ACTION

What the Click of a Button Can Mean for Patient Access to Medication

Pharmacist Priyank Patel, owner of Felicity Pharmacy in New York City, noticed a patient was only picking up her insulin prescription every other month, instead of monthly. He knew it was unlikely she was taking it as prescribed and when asked, her reason was simple: she could not afford the medication each month.

“Patients aren’t going to reach their therapeutic goals if they can’t afford or their insurance doesn’t cover the medication,” said Patel. He noted that navigating the relationship between drug costs, health plans and patients’ ability to afford their medications was not something taught in pharmacy school – but is a large part of the job as a community or retail pharmacist.

Patel knew he could help this patient and turned to Surescripts Real-Time Prescription Benefit to learn more about possible therapeutic alternatives that would be covered by her health plan.

“I used the real-time prescription benefit checker and saw that she can be on a different long-acting insulin that would reduce her copay to zero. She would be able to take it the way the doctor prescribed it to her.” When Patel shared this information with her, “immediately, it almost brought my patient to tears.”

“It’s a great feeling as a pharmacist that you actually made a difference with a simple click of a button.”

– Pharmacist Priyank Patel, Owner of Felicity Pharmacy

Patel shared this experience with Dr. Andrew Mellin, Chief Medical Information Officer at Surescripts, and Dr. Nele Jessel, Chief Medical Officer at athenahealth, on a recent Modern Healthcare webinar. The webinar focused on improving the medication prescribing process and increasing medication affordability and adherence for patients.

Watch: Effective tools to improve medication affordability and adherence

Accurate Prescription Information Enhances Patient Trust

As an internist, Mellin explained there are only a few tools in the toolbox available to treat patients and prescription medications are among the most effective options they have.

Yet, sticker shock at the cost of these drugs is not only upsetting for patients, it means more calls and administrative work by prescribers and pharmacists, a known cause of provider burnout. It also means providers spend less time helping patients.

“Electronic tools better align pharmacists and providers. They truly make pharmacists part of the care team.”

– Dr. Nele Jessel, Chief Medical Officer at athenahealth

Jessel explains that the impact of unaffordable prescription drugs is “even worse because it undermines all our credibility. It makes patients much less likely to trust us when their gut reaction is ‘why would she prescribe this for me?’”

It is “extremely helpful to have this information at the point of care, to decide is there a less expensive alternative, is it better if I send a 90-day prescription versus a 30 day. It’s helpful to see the cost differences between brands and generics,” notes Jessel.

Mellin also shared that Surescripts Real-Time Prescription Benefit has been adopted at a faster pace than any healthcare technology he’s seen in his decades long career. He noted that a recent study of 34 million new electronic prescriptions informed by Surescripts Real-Time Prescription Benefit saw prescription pickup rates that were 3.2 percentage points higher those where it wasn’t used.

Read more about medication affordability and adherence on Intelligence in Action.

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